@article{2996918, title = "Machine learning based analysis of stroke lesions on mouse tissue sections", author = "Damigos, G. and Zacharaki, E.I. and Zerva, N. and Pavlopoulos, A. and Chatzikyrkou, K. and Koumenti, A. and Moustakas, K. and Pantos, C. and Mourouzis, I. and Lourbopoulos, A.", journal = "Journal of Cerebral Blood Flow and Metabolism", year = "2022", publisher = "SAGE Publications Ltd", issn = "0271-678X, 1559-7016", doi = "10.1177/0271678X221083387", abstract = "An unbiased, automated and reliable method for analysis of brain lesions in tissue after ischemic stroke is missing. Manual infarct volumetry or by threshold-based semi-automated approaches is laborious, and biased to human error or biased by many false -positive and -negative data, respectively. Thereby, we developed a novel machine learning, atlas-based method for fully automated stroke analysis in mouse brain slices stained with 2% Triphenyltetrazolium-chloride (2% TTC), named “StrokeAnalyst”, which runs on a user-friendly graphical interface. StrokeAnalyst registers subject images on a common spatial domain (a novel mouse TTC- brain atlas of 80 average mathematical images), calculates pixel-based, tissue-intensity statistics (z-scores), applies outlier-detection and machine learning (Random-Forest) models to increase accuracy of lesion detection, and produces volumetry data and detailed neuroanatomical information per lesion. We validated StrokeAnalyst in two separate experimental sets using the filament stroke model. StrokeAnalyst detects stroke lesions in a rater-independent and reproducible way, correctly detects hemispheric volumes even in presence of post-stroke edema and significantly minimizes false-positive errors compared to threshold-based approaches (false-positive rate 1.2–2.3%, p < 0.05). It can process scanner-acquired, and even smartphone-captured or pdf-retrieved images. Overall, StrokeAnalyst surpasses all previous TTC-volumetry approaches and increases quality, reproducibility and reliability of stroke detection in relevant preclinical models. © The Author(s) 2022." }